Although the cost of nursing home and assisted-living care has risen 4 percent per year for the past five years, the cost of in-home care has remained relatively unchanged, according to data collected by Genworth Financial.

That makes in-home care the preferred option for many long-term care clients. However, a recent Department of Labor decision and the proposed $15 minimum wage could cause an increase in home-care costs, limiting home-care options for many seniors who wish to stay at home and age in place.

The U.S. Department of Labor decided in October to reverse a rule called the Companionship Services Exemption. In a press release, the DOL said, “This change … ensures that nearly 2 million workers —– such as home health aides, personal care aides, and certified nursing assistants — will have the same basic protections already provided to most U.S. workers.”

The department is referring to overtime and minimum wage standards set up under the federal Fair Labor Standards Act (FLSA). Under these rules, workers must be paid at least the federal minimum wage of $7.25 an hour and must be eligible to receive at least time-and-a-half pay for all hours worked over 40 in a given week.

People employed in companionship services had been exempt from those standards. Now, the updated rules will apply to all caregivers who work for an agency, and to privately hired caregivers if those caregivers spend at least 20 percent of their work week assisting with care-related duties, such as bathing, feeding and housekeeping.

While the new regulations may seem commonplace, we need to look at the true effects these changes may have on the availability and affordability of in-home care. Currently, if a client needs live-in care, a caregiver can be hired, usually through an agency, and care will be provided around the clock by a team of two caregivers. The client pays a flat fee for this service; the caregivers are paid a flat, nonhourly wage from the agency.

However, the above situation will change dramatically once the companionship exemption is removed.

First, due to the overtime rules, a live-in care client could begin to see as many as four to six caregivers a week, rather than the two the client may be accustomed to seeing. Opponents of the new regulation believe this could cause a disruption in the continuity of care.

Second, reflecting the minimum wage mandate, the live-in client would most likely see an hourly charge on the bill rather than a flat daily fee, causing a substantial fee increase.

If costs were to rise in this way, many elderly and disabled individuals could be priced out of being able to afford care in their homes. The other two most likely choices are arranging care through a family member or moving into a long-term care community.

An additional concern for Seattle residents is the potential increase in the minimum wage to $15 an hour. If this were to pass, it would increase hourly care rates by as much as 15 percent. One encouraging note is that unlike the exemption, the $15 minimum wage is not yet set in stone. Some are optimistic that the change may not be placed on the ballot or may not be approved.

The fact remains that the number of American adults age 65 or older is set to double by 2030. According to statistics in the National Medicare Handbook, 70 percent of those over age 65 will need some form of long-term care assistance in their lifetime.

The need for in-home care will continue to rise, and whether the removal of the Companionship Services Exemption leads to a positive or negative impact on the industry remains to be seen. However, both agencies and individuals receiving care would be smart to prepare now for the upcoming changes.

The Department of Labor has set up a website to advise businesses, caregivers, and individuals on how the change to the exemption may affect them.Visit the department's website to walk through an interactive checklist to see how the changes may impact your situation.